Rebecca Cardigan, BSc, PhD; Sheila Maclennan , MBBS, FRCP, FrCPath

Disclosures

Transfusion Alter Transfusion Med. 2008;10(3):92-101. 

In This Article

Preparation and Storage of Granulocytes

Granulocytes may be transfused to patients with a severe deficiency or dysfunction of neutrophils which have developed or are at risk of developing life-threatening infections. There is anecdotal evidence of benefit, but few randomized controlled trials have been performed, and a recent systematic review found that there is inconclusive evidence from randomized controlled trials (RCTs) to support or refute the generalized use of granulocyte transfusion therapy in neutropenic patients.[10] Granulocytes are normally collected by apheresis and contain mainly neutrophils but also significant numbers of lymphocytes, red cells and platelets; hence they need to be crossmatched prior to transfusion. Preadministration of steroids and granulocyte-colony stimulating factor (G-CSF) to donors can considerably increase the yields collected (1-10 × 1010), but this is not permitted in volunteer donors in some countries. Yields in unstimulated donations rarely exceed 0.5 × 1010, which is below the dose generally considered adequate for adults (> 1 × 1010). Because of the logistical and ethical constraints in providing apheresis granulocytes, some countries issue buffy coats as a source of granulocytes. Ten to twelve buffy coats are transfused to provide a dose of 1 × 1010 neutrophils.

Granulocytes should be transfused as soon as possible after collection or preparation but can be stored at 22°C for up to 24 hours without agitation and are irradiated prior to transfusion to prevent transfusion-associated graft-versus-host disease (TA-GVHD) (see below).

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